Waller, Kenneth William

Waller, Kenneth William is an individual health care provider with primary practice located at 100 Emancipation Dr , Hampton VA 23667-0001. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Spinal Cord Injury Medicine, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Spinal Cord Injury Medicine is his primary health care specialty. Waller, Kenneth William can be contacted via phone (757) 722-9961.

Contact Information

Primary practice address
100 Emancipation Dr Hampton VA 23667-0001
Phone: (757) 722-9961
Fax: (757) 726-6078
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Spinal Cord Injury Medicine 2081P0004X 0101040108 Virginia
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 0101040108 Virginia

Profile Details

NPI number 1518921238
LBN Legal business name Waller, Kenneth William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 12th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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